R&B Solutions, a Medicaid Advocacy company based out of Waukegan, Illinois, successfully challenged the state’s “sudden onset” requirement on behalf of an undocumented immigrant whose Medicaid eligibility was denied based on existing symptoms that lacked “sudden onset.” In Elvira Arellano v. Illinois Department of Human Services, the 2nd District Appellate Court ruled that the sudden onset language that the Department of Human Services added to the federal Medicaid regulation, which Illinois’ regulation mirrors, impermissibly modifies the federal Medicaid statute that does not contain the sudden onset language and cannot be enforced.

Elvira Arellano, a low-income undocumented immigrant mother without health insurance, had a cough, which she attributed to a minor cold and treated as such. As her breathing difficulties went unresolved with normal home remedies, she sought medical attention at a free clinic that provided her some pharmaceuticals to treat it. When Arellano’s condition...